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OBJECTIVE: To assess the diagnostic validity of ICDAS clinical criteria on 3D dental models from intraoral scanning. METHODS: This is a retrospective analysis on part of the baseline sample collected in a cohort study and included 73 participants (12-19 years) from Denmark and Greece. The assessment was made by visual inspection, and then by visual inspection associated with radiographs. All participants were scanned with TRIOS 4 which uses white light to obtain the 3D models with tooth color, as well as blue light source (415 nm) for fluorescence. The 3D models' evaluation was conducted using tooth-color texture and subsequently fluorescence. Two scores were obtained for the 3D model examination: i) ICDAS based on tooth-color information; ii) ICDAS based on tooth-color information supplemented with fluorescence. For the analysis, weighted kappa, sensitivity (SE), specificity (SP) and accuracy (ACC) were calculated. RESULTS: Regarding all lesions the values for SE, SP, and ACC were respectively 0.804, 0.801, and 0.802 for tooth-color, and 0.819, 0.808, and 0.810 for tooth-color supplemented with fluorescence. In terms of accuracy parameters for moderate-extensive lesions, the values for SE, SP, and ACC for tooth color were 0.709, 0.948, and 0.944, while for fluorescence they were 0.815, 0.937, and 0.934. CONCLUSION: Caries assessment with ICDAS criteria on 3D dental models produces reliable scores. Visual caries analysis using 3D models demonstrates commendable diagnostic accuracy and reasonable consistency with traditional methods. The use of intraoral scanners may be beneficial in evaluating occlusal caries. CLINICAL SIGNIFICANCE: The importance of this study is to prove the diagnostic accuracy of caries lesions diagnosis made using and intraoral scanner and to offer greater confidence to professionals who use this diagnosis tool in their daily clinical practice. Intraoral scanners demonstrate to be an accurate tool for diagnosing occlusal caries.
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Introduction The International Caries Classification and Management System (ICCMS) was developed to standardise caries diagnosis, risk assessment and treatment decisions based on overall evidence. To evaluate its criteria in practice, a clinical trial assessed professionals' perceptions of two caries management systems.Methods A perception questionnaire was administered to two groups: one using ICCMS criteria and the other based on professional experience criteria (non-ICCMS group). The online questionnaire included quantitative scale questions to measure effort and satisfaction and two open-ended questions to collect the positive and negative perceptions of dentists by using either criteria system. The questionnaires were administered six months after the study's implementation.Results Both groups showed high levels of effort and satisfaction. Professionals using ICCMS reported more positive perceptions by citing improved diagnosis (71.4%) and standardised patient care (43%). However, they also noted negative aspects, such as increased number of questionnaires and records (58%), longer clinical sessions (43%) and higher rates of patient absenteeism (29%).Conclusion Professionals who used the ICCMS had a positive outlook on the system, with benefits seen in diagnosis and patient monitoring. However, there is room for improvement in terms of automation and simplification to enhance the professional use of the system in the clinical setting.
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AIM: The aim of this randomized clinical trial was to compare the impact of two management options for primary molars with pulp necrosis (pulpectomy or extraction) on children's oral health-related quality of life (OHRQoL). DESIGN: A total of 100 children aged 3-5 years with at least one necrotic primary molar were selected and randomized into the study groups. The Brazilian version of early childhood oral health impact scale (B-ECOHIS) was completed by the parent proxy reports at baseline and after 4, 8 and 12 months. Differences between the trial groups were assessed through bootstrap linear regression for B-ECOHIS scores, logistic regression for dental pain self-reports and anxiety scores (α = 5%). RESULTS: The mean (SD) B-ECOHIS scores at baseline and after 12 months were 17.7 (6.5) and 3.0 (4.0) in the pulpectomy group and 18.8 (7.7) and 7.9 (7.7) in the extraction group. Both treatments significantly improved OHRQoL, but tooth extraction group showed higher scores in total B-ECOHIS (p < .001) and most domains, indicating lower OHRQoL. Furthermore, higher anxiety levels were reported for dental extraction compared to pulpectomy (OR = 2.52; p = .008). CONCLUSION: Pulpectomy resulted in an improved OHRQoL scores after 12 months when compared to tooth extraction and should be considered as the treatment of choice for necrotic primary molars.
Subject(s)
Dental Caries , Quality of Life , Child, Preschool , Humans , Dental Care , Dental Caries/therapy , Oral Health , Pulpectomy/methods , Tooth ExtractionABSTRACT
BACKGROUND: Published information on the teaching and recognition of paediatric dentistry (PD) is limited worldwide. AIM: The aim of this study was to investigate the status of current teaching of undergraduate and postgraduate training in PD and identify differences by country-level economic development. DESIGN: Representatives from 80 national member societies of the International Association of Paediatric Dentistry (IAPD) were invited to complete a questionnaire on undergraduate and postgraduate PD curricula, types of postgraduate education offered, and recognition of the specialty. Country economic development level was classified according to the World Bank criteria. The chi-squared test and the Spearman correlation coefficient were used for data analysis (α = 0.005). RESULTS: Response rate was 63%. Teaching of PD at the undergraduate level was present in all countries, but PD specialization, master's, and Doctor of Philosophy (PhD) coursework were offered in 75%, 64%, and 53% of surveyed countries, respectively. Postgraduate specialization courses were offered in a significantly larger proportion of high-income countries than in upper-middle- or lower-middle-income countries (p < .01). In 20% of participating countries, PD was not an officially recognized specialty with no difference in recognition of the specialty by country's economic development level (p = .62). CONCLUSION: Paediatric dentistry is taught at the undergraduate level universally, but at the postgraduate level, significantly fewer courses are available, especially in lower-income countries.
Subject(s)
Curriculum , Pediatric Dentistry , Humans , Child , Surveys and QuestionnairesABSTRACT
Introducción: El virus del papiloma humano (VPH) es un factor etiológico de diversas enfermedades de la mucosa oral y de la piel que pueden derivar en neoplasias malignas. La vacunación es la principal forma de prevención, inmunizando a las niñas de 9 a 13 años y a los niños de 11 a 13 años. Todavía no hay consenso sobre la prevalencia del virus VPH en niños. Objetivo: Verificar la prevalencia del VPH en niños de 1 a 13 años a partir de una base de datos de informes de biopsias de lesiones diagnosticadas de papiloma analizadas en un laboratorio nacional de referencia. Material y métodos: Se analizaron los informes anatomopatológicos de biopsias recibidas por el Laboratorio de Patología Oral y Maxilofacial de la Facultad de Odontología de la Universidad de São Paulo en un período de 20 años, de 2002 a 2022. También se recogieron informaciones sobre sexo, localización de la lesión e hipótesis diagnóstica. Resultados: En una base de datos de 93.950 informes, 4.203 comprendían el grupo de edad analizado y 99 (2,3%) tenían diagnóstico de papiloma. El porcentaje de varones y mujeres fue similar, 50,5% y 49,5% respectivamente. La localización más frecuente fueron los labios (48%). Las hipótesis diagnósticas más citadas fueron epulides y verruga vulgar. Conclusión: La prevalencia del papiloma en niños brasileños de 1 a 13 años fue del 2,3%. El reconocimiento de las características clínicas de las lesiones es esencial para el diagnóstico correcto y la intervención precoz, así como la orientación.
Introdução: O papiloma vírus humano (HPV) é fator etiológico para diversas doenças na mucosa oral e na pele que podem sofrer processo de malignização. A vacinação é a principal forma de prevenção, imunizando meninas de 9 a 13 anos e meninos de 11 a 13 anos. Ainda não há um consenso sobre a prevalência do vírus HPV em crianças. Objetivo: Verificar a prevalência de HPV em crianças de 1 a 13 anos de idade com base em um banco de laudos de lesões biopsiadas com diagnóstico de papiloma analisadas em um laboratório de referência nacional. Material e Métodos: Foi feita a análise de laudos anatomopatológicos de biópsias recebidas pelo Laboratório de Patologia Bucal e Maxilofacial da Faculdade de Odontologia da Universidade de São Paulo em um período de 20 anos, compreendido entre ao anos 2002 a 2022. Informações de sexo, localização da lesão e hipóteses diagnósticas também foram coletadas. Resultados: Em um banco de 93.950 laudos, 4.203 compreendiam a faixa etária analisada e 99 (2,3%) tinham o diagnóstico de papiloma. A porcentagem de laudos do sexo masculino e feminino foi similar, sendo 50,5% e 49,5%, respectivamente. A localização da lesão mais frequente encontrada foi a região dos lábios (48%). Hipóteses diagnósticas mais citadas foram epúlide e verruga vulgar. Conclusão: A prevalência de papiloma em crianças brasileiras de 1 a 13 anos foi de 2,3%. Reconhecer características clínicas das lesões é essencial para um correto diagnóstico e intervenção precoce bem como para evitar o agravamento da doença.
Introduction: Human papillomavirus (HPV) is an etiologic factor for several diseases of the oral mucosa and skin that can undergo a malignant process. Vaccination is the most important form of prevention, with girls being vaccinated between the ages of 9 and 13 and boys between the ages of 11 and 13. There is still no consensus on the prevalence of the HPV virus in children. Aim: To review the prevalence of HPV in children aged 1 to 13 years based on a database of reports of biopsied lesions diagnosed with papilloma analyzed in a national reference laboratory. Material and methods: Anatomic-pathologic reports of biopsies received at the Oral and Maxillofacial Pathology Laboratory of the Faculty of Dentistry of the College of São Paulo were analyzed over a 20-year period, between 2002 and 2022. Information on gender, lesion location and diagnostic hypotheses was also collected. Results: In a database of 93,950 reports, the age group analyzed accounted for 4,203 and 99 (2.3%) were diagnosed with papilloma. The proportion of male and female reports was similar at 50.5% and 49.5% respectively. The most common location of the lesion found was the lip region (48%). The most frequently cited diagnostic hypotheses were epulis and verruca vulgaris. Conclusion: The prevalence of papillomas in Brazilian children aged 1 to 13 years was 2.3%. Early diagnosis and advice on HPV vaccination can prevent and avoid exacerbation of the disease. Recognizing the clinical features of lesions is essential for correct diagnosis and early intervention and counseling
Subject(s)
Humans , Infant , Child, Preschool , Child , Adolescent , BrazilABSTRACT
The aim of this paper was to present a summary of the process of developing and preparing the final documents of the national consensus for teaching undergraduate Brazilian dental students the dental caries curriculum in the Portuguese language. The final document was developed in three steps: a) The ABENO and LAOHA cariology group invited experts from all five regions of Brazil to participate in the discussion. The theoretical support for crafting the first draft of the consensus was based on two publications: National Curriculum Guidelines of the Dentistry graduation in Brazil, Ministry of Education (2021) and the competences described in the European Core Curriculum for Cariology (ORCA-ADEE, 2011); b) The group of experts was divided into 5 working groups: G1-Domain, Main and Specific Competences, G2-Essential knowledge, G3-Life course perspective, G4-Social determinants and dental caries, G5- Glossary. The document was finalized by thoroughly reviewing the process using Delphi methodology; c) The 5-chapter document (one from each working group) was submitted to three open public consultations in 2022 (May-June, August, and October) using Google-forms. The suggestions (content/wording) were discussed within the group as: totally accepted, partially accepted, and rejected. A total of 192 suggestions were registered from 31 dental schools in all regions of Brazil. The number of suggestions received per Group were: 84, 28, 26, 24, 30 suggestions for G1, G2, G3, G4 and G5, respectively. The majority of suggestions were totally accepted by the group of experts (n = 172, 89.6%), 15 were partially accepted (7.8%), and 5 were rejected. Conclusion The final document could be considered to be the first national consensus for teaching the dental caries curriculum in Brazil.
Subject(s)
Dental Caries , Humans , Consensus , Brazil , Dental Caries/prevention & control , Schools, Dental , Portugal , Education, Dental , Curriculum , LanguageABSTRACT
Policy evaluation and guidance on fluoride use and sugar consumption in Latin American and Caribbean countries (LACC) may provide a scientific evidence basis for policymakers, dental professionals, civil society organizations and individuals committed to improving public oral health. A cross-sectional study was conducted to evaluate the extent of implementation of policies/guidelines on fluoride use, and sugar consumption in LACC. The study had two stages. First a questionnaire covering four major areas was developed: fluoridation of public water supplies; salt fluoridation; fluoride dentifrices, and sugar consumption. Then, the questionnaire was applied to collect data among representative participants in public oral health from LACC. Ninety-six participants from 18 LACC answered the questionnaire. One-hundred seventy documents were attached, and 285 links of websites were provided by the respondents. Implementation of policies and guidelines on water and table salt fluoridation and processed and ultra-processed food consumption were found in most countries, with some issues in the consensus and coverage. Thus, differences were identified in the extent of implementation of public oral health strategies on sugar consumption and fluoridation among the countries. There is no consensus on the policies in LACC to reduce sugar consumption and for the use of fluoride. A few policies and guidelines were applied in isolated countries, with a variety of strategies and standards. For future actions, it will be important to encourage the development of strategies and public policies within countries, and to evaluate the effectiveness of existing policies in reducing dental caries and in improving oral health in LACC.
Subject(s)
Dental Caries , Fluorides , Humans , Dental Caries/prevention & control , Sugars , Cross-Sectional Studies , Latin America , Fluoridation , Policy , Dietary Sugars , Caribbean RegionABSTRACT
Oral health personnel must acknowledge the health needs of sexual and gender minorities. They should consult scientific literature to deepen their knowledge about sexuality, gender identity, general and oral health status, and treatment disparities among LGBTQIA+ people. The aim of this scoping review was to portray the development and current stage of internationally indexed literature approaching the oral health of this population. In this study, the search strategy used consisted of combinations of subject descriptors (MeSH terms), in two concept blocks: LGBTQIAP+ people and oral health. Global literature was searched through Medline (PUBMED), Web of Science, Embase, Lilacs, and Scopus electronic databases, with no language or date restrictions. Records were selected and evaluated by two independent reviewers, under the supervision of three senior reviewers and the inclusion criteria resulted in 189 eligible papers. Since the first study was published in 1974, numbers increased over the decades, reaching 67 (35.4%) in 2010-2019. The most frequently studied populations were North American (42.9%) and European (19.0%) and the most frequent language of publication was English (99.0%). There were 38 open access papers (20.1%). Medical (57.7%) and dental journals (20.1%) predominated. Cross-sectional studies were found more frequently (65.1%), followed by the cohort type (11.1%). Oral manifestation of STI (58.7%) was the topic most frequently addressed. The search for literature approaching the oral health of LGBTQIAP+ people showed evidence of the need to encourage research reported in papers made easily available, with more robust scientific evidence, and on a broader scope of topics, including oral health needs and treatment, and planning of oral health services.
Subject(s)
Gender Identity , Oral Health , Sexual and Gender Minorities , Female , Humans , Male , Cross-Sectional Studies , Health Services Needs and DemandABSTRACT
This study aimed to investigate the impact of dental caries and tooth loss on oral health-related quality of life (OHRQoL) in socioeconomically disadvantaged people. A population-based, cross-sectional survey was conducted in 28 cities at social risk in Northeast Brazil. All permanent residents aged 12, 15-19, 35-44, and 65-74 years were eligible, and 3063 were included. Participants answered a questionnaire on socioeconomic status, beliefs, and behaviors. Trained local dentists performed oral clinical examinations during home visits. Caries and tooth loss were evaluated using the decayed, missing, and filled teeth (DMFT) index and OHRQoL was evaluated using the Oral Health Impact Profile-14 (OHIP-14). Poisson regression analysis was performed to assess the relationship between individual domains, OHIP-14 scores, dental caries, tooth loss, and socioeconomic/demographic characteristics. Mean DMFT (standard deviation) scores were 2.68 (4.01), 4.84 (4.30), 15.35 (7.26), and 26.72 (8.03) for groups aged 12, 15-19, 35-44, and 65-74 years, respectively. Most participants (70%) were partially edentulous and 13% were completely edentulous. Caries and tooth loss significantly increased with age and impacted OHRQoL. Physical pain (5.8%) and psychological discomfort (5.8%) were the most commonly reported on the OHIP-14. Untreated caries (prevalence ratio (PR), 1.54; 95% confidence interval (CI), 1.37-1.72) and edentulism (PR, 1.29; 95% CI, 1.08-1.53) had a significant negative impact on OHRQoL. Income, level of education, sex, age, and oral hygiene habits were also related to OHRQoL. There was a high prevalence of dental caries and edentulism in all age groups except 12-year-olds. OHRQoL was negatively impacted by these oral conditions across the lifespan, with a trend towards more negative scores and higher impact in older adults.
Subject(s)
Dental Caries , Tooth Loss , Humans , Aged , Tooth Loss/epidemiology , Quality of Life , Brazil/epidemiology , Cross-Sectional Studies , Dental Caries/epidemiology , Risk FactorsABSTRACT
OBJECTIVE: To identify oral characteristics found in children with liver disease in programming for liver transplantation. DATA SOURCE: The methodology was written according to PRISMA-ScR. We adopted the methodological framework and recommendations for this type of review by Arksey and O'Malley and the Joanna Briggs Institute. The protocol was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). A systematic search (Medline/PubMed, Scopus, Web of Science, and ProQuest) was conducted to identify studies that met the inclusion criteria: systematic reviews; prospective clinical trials (parallel or crossover group designs); observational studies (cohort, case-control, and cross-sectional studies); clinical case series; and case reports evaluating children with liver disease in preparation for transplantation. The last search was conducted in July 2021, and no restrictions were imposed as to language or year of publication. Studies presenting mixed data with post-transplant evaluation, and studies evaluating not only liver transplantation but also other solid organs were excluded. Screening, inclusion, and data extraction were performed by two reviewers independently. A narrative synthesis was conducted to describe the findings of the study. DATA SYNTHESIS: The bibliographic search identified 830 references. A total of 21 articles were read in their entirety after the inclusion criteria assessment. Finally, after evaluating the exclusion criteria, only 3 studies were considered for the qualitative analysis. CONCLUSIONS: Children with liver disease in preparation for transplantation may present enamel defects, tooth pigmentation, caries, gingivitis, and opportunistic infections such as candidiasis.
Subject(s)
Liver Diseases , Liver Transplantation , Child , Humans , Cross-Sectional Studies , Prospective StudiesABSTRACT
The aim of this manuscript is to describe a hybrid care model to paediatricpatients on a virtual basis for dental treatment before conducting an in-person surveillance by using combined nasal/oral swabbing (NOS).This longitudinal study used a convenience sample of paediatric patients and members of the dental team from an undergraduate paediatric dentistry clinic at the University of São Paulo School of Dentistry during the COVID-19 pandemic. Firstly, parents werecontacted and teledentistry was used for screening children who need dental treatment. Appointments were scheduled once a week for two months, in which a pre-COVID-19 screening was performed. Dental team and children's parents completed a questionnaire addressing COVID-19-related symptoms. Members of the dental team and children were tested for COVID-19 before entering the dental clinic, by NOS and RT-PCR screening.Ninety-three individuals were enrolled and all of them completed the electronic questionnaire on symptoms and had NOS collected weekly, totalising 241 pairs of swabs. No participant reported COVID-19 symptomsbefore entering the clinic for treatment. Only one child tested positive in the third week of sampling. The hybrid care model associated with molecular testing for asymptomatics provided a safe clinical environment regarding the transmission of SARS-CoV-2 (AU).
El propósito de este manuscrito es describir un modelo híbrido de atención odontológica, a través de una plataforma virtual que precede a la realización de vigilancia molecular presencial mediante hisopado nasal/oral combinado, en pacientes pediátricos. Eneste estudio longitudinal se utilizó una muestra de conveniencia de pacientes pediátricos y miembros del equipo odontológico en la clínica de pregrado de la Facultad de Odontología de la Universidade de São Paulo durante la pandemia de COVID-19. En primerlugar, se contactó con los padres y se utilizó la consulta virtual para seleccionar a los niños que requerían tratamiento odontológico. Se programaron citas una vez a la semana durante dos meses, en las que se realizó el cribado previo a COVID-19. El equipo dental y los padres de los niños rellenaron un cuestionario en el que se abordaban los síntomas relacionados con la COVID-19. A continuación, los miembros del equipo dental y los niños fueron sometidos a pruebas de detección de COVID-19 antes de entrar en la clínica para atendimiento mediante cribado con hisopo nasal/oral y RT-PCR. Se inscribieron 93 personas, todas las cuales cumplimentaron el cuestionario electrónico sobre síntomas y se les recogieron muestras semanalmente, con un total de 241 pares dehisopos. Ningún participante declaró síntomas de COVID-19 antes de entrar en la clínica para recibir tratamiento. Sólo un niño dio positivo en la tercera semana de toma de muestras. El modelo de tratamiento híbrido unido a las pruebas moleculares para asintomáticos proporcionó un entorno clínico seguro con respecto a la transmisión del SARS-CoV-2 (AU).
O objetivo deste manuscrito é descrever um modelo de atendimento odontológico híbrido, por meio de uma plataforma virtual anterior a realização de uma vigilância molecular presencial usando esfregaço combinado nasal/oral, em pacientes pediátricos. Este estudo longitudinal utilizou uma amostra de conveniência de pacientes pediátricos e membros da equipe odontológica na clínica de graduação da Faculdade de Odontologia da Universidade de São Paulo durante a pandemia COVID-19. Primeiro, os pais foram contactados e a consulta virtual foi utilizada para o rastreio de crianças que necessitavam de tratamento odontológico. Foram agendadas consultas uma vez por semana durante dois meses, nas quais foi realizado um rastreio pré-COVID-19. A equipe odontológica e os pais das crianças preencheram um questionário que abordava os sintomas relacionados com a COVID-19. Em sequência, os membros da equipe odontológica e as crianças foram testados para o COVID-19 antes de entrarem na clínica para atendimento, através do rastreio com esfregaço nasal/oral e RT-PCR. Noventa e três indivíduos foram inscritos e todos eles preencheram o questionário eletrônico sobre os sintomas e tiveram amostras coletadas semanalmente, totalizando 241 pares de cotonetes. Nenhum participante comunicou sintomas de COVID-19 antes de entrar na clínica para tratamento. Apenas uma criança testou positivo na terceira semana de amostragem. O modelo de tratamento híbrido associado a testes moleculares para assintomática proporcionou um ambiente clínico seguro no que diz respeito à transmissão da SARS-CoV-2 (AU).
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Humans , Male , Female , Infant , Child, Preschool , Child , Surveys and QuestionnairesABSTRACT
Background: To assess the prevalence of oral and maxillofacial malignant neoplasias in children and adolescents diagnosed through biopsies sent to the Oral Pathology Laboratory at the University of Sao Paulo School of Dentistry. Material and methods: A retrospective analysis of anatomopathological reports on patients between 1 and 18 years old issued by the oral and maxillofacial pathology laboratory between 1997 and 2021 was performed for demographic data, lesion site, type of biopsy, diagnostic hypothesis and final diagnosis. Results: The laboratory issued 76,194 anatomopathological reports during this period, of which 10.77% were of children and adolescents. Of this total, only 32 biopsies (32/8.204; 0.39%) were neoplasias in children and adolescents. Sarcomas were the most prevalent malignant neoplasms (19/32; 59%), followed by carcinomas (7/32; 22%), lymphomas (5/32; 16%) and ganglioneuroblastomas (1/32; 3%). Of these 32 patients, the most affected individuals were aged between 4 and 11 years old (47%), 18 (56%) were male, and the mandible was the main anatomical site involved (28%). In 41% of the cases (13/32), the diagnostic hypothesis of the biopsied lesion was mistakenly considered benign and there was no diagnostic hypothesis in 18% of the cases. Conclusions: Oral and maxillofacial malignant neoplasms in children and adolescents are uncommon and the accuracy of provisional diagnoses is low in these cases. Better knowledge on oral and maxillofacial malignant lesions in this population would help professionals to reduce the diagnostic time and consequently improve the patient's prognosis. (AU)
Subject(s)
Humans , Male , Female , Infant , Child, Preschool , Child , Adolescent , Head and Neck Neoplasms , Pediatrics , Brazil/epidemiology , Retrospective Studies , Prevalence , BiopsyABSTRACT
Epidemiological data on the distribution of oral and maxillofacial diseases present in early childhood are scarce in the literature. This study analyzed the frequency of lesions biopsied in this region in children aged 0 to 3 years and sent for histopathological analysis in a reference oral pathology laboratory . Histopathological diagnostic data, lesion location, sex, and age were collected. Of the total of 93,950 records, 250 cases (0.27%) belonged to the age group from 0 to 3 years old. The most frequently diagnosed oral alterations were: mucocele (34/250; 13.6%); papilloma (11/250; 4.4%), giant cell fibroma (6/250; 2.4%), pyogenic granuloma (5/250; 2%) and hemangioma (3/250; 1.2%). The lip was the most affected site, followed by the gingiva and the tongue. These results generate information on the lesions most frequently diagnosed in early childhood, which facilitates the process of diagnosis and, consequently, treatment.
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OBJECTIVES: Previous cohort studies have found a positive association between prolonged breastfeeding (≥12 months) on dental caries, but few of them analysed the mediated effect of sugar consumption on this association. This study investigated whether prolonged breastfeeding is a risk factor for caries at 2-year follow-up assessment (21-27 months of age) and whether this effect is mediated by sugar consumption. METHODS: A birth cohort study was performed in the Brazilian Amazon (n = 800). Dental caries was assessed using the dmf-t index. Prolonged breastfeeding was the main exposure. Data on baseline covariables and sugar consumption at follow-up visits were analysed. We estimated the OR for total causal effect (TCE) and natural indirect effect (NIE) of prolonged breastfeeding on dental caries using the G-formula. RESULTS: The prevalence of caries was 22.8% (95% CI: 19.8%-25.8%). Children who were breastfed for 12-23 months (TCE = 1.13, 95% CI: 1.05-1.20) and for ≥24 months (TCE = 1.27, 95% CI: 1.14-1.40) presented a higher risk of caries at age of 2 years than those breastfed <12 months. However, this risk was slightly mediated by a decreased frequency of sugar consumption at age of 2 years only for breastfeeding from 12 to 23 months (NIE; OR = 0.95, 95% CI: 0.91-0.97). CONCLUSIONS: In this study, the effect of prolonged breastfeeding on the increased risk of dental caries was slightly mediated by sugar consumption. Early feeding practices for caries prevention and promoting breastfeeding while avoiding sugar consumption should be targeted in the first 2 years of life.
Subject(s)
Breast Feeding , Dental Caries , Child , Female , Humans , Child, Preschool , Breast Feeding/adverse effects , Cohort Studies , Dental Caries/epidemiology , Dental Caries/etiology , Dental Caries/prevention & control , Sugars , Dietary Sugars/adverse effectsABSTRACT
Abstract Objective: To identify oral characteristics found in children with liver disease in programming for liver transplantation. Data source: The methodology was written according to PRISMA-ScR. We adopted the methodological framework and recommendations for this type of review by Arksey and O'Malley and the Joanna Briggs Institute. The protocol was registered in the Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). A systematic search (Medline/PubMed, Scopus, Web of Science, and ProQuest) was conducted to identify studies that met the inclusion criteria: systematic reviews; prospective clinical trials (parallel or crossover group designs); observational studies (cohort, case-control, and cross-sectional studies); clinical case series; and case reports evaluating children with liver disease in preparation for transplantation. The last search was conducted in July 2021, and no restrictions were imposed as to language or year of publication. Studies presenting mixed data with post-transplant evaluation, and studies evaluating not only liver transplantation but also other solid organs were excluded. Screening, inclusion, and data extraction were performed by two reviewers independently. A narrative synthesis was conducted to describe the findings of the study. Data synthesis: The bibliographic search identified 830 references. A total of 21 articles were read in their entirety after the inclusion criteria assessment. Finally, after evaluating the exclusion criteria, only 3 studies were considered for the qualitative analysis. Conclusions: Children with liver disease in preparation for transplantation may present enamel defects, tooth pigmentation, caries, gingivitis, and opportunistic infections such as candidiasis.
RESUMO Objetivo: Identificar características bucais em crianças hepatopatas em programação para o transplante hepático. Fontes de dados: A metodologia foi descrita de acordo com o PRISMA-ScR. Adotamos a estrutura metodológica e recomendações para este tipo de revisão por Arksey e O'Malley e o Instituto Joanna Briggs. O protocolo foi registrado no Open Science Framework (https://doi.org/10.17605/OSF.IO/QCU4W). Uma pesquisa sistemática (Medline/PubMed, Scopus, Web of Science e ProQuest) foi conduzida para identificar estudos que preenchessem os critérios de inclusão: revisões sistemáticas; ensaios clínicos prospectivos (desenhos de grupos paralelos ou cruzados); estudos observacionais (coorte, caso-controle e estudos transversais); séries de casos clínicos; e relatos de casos que avaliam crianças com doenças hepáticas em preparação para o transplante. A última busca foi conduzida em julho de 2021, e não foram impostas restrições quanto ao idioma ou ano de publicação. Foram excluídos estudos que apresentavam dados mistos com avaliação pós-transplante e estudos que avaliavam não só o transplante de fígado, mas também de outros órgãos sólidos. O rastreio, inclusão e extração de dados foram realizados por dois revisores independentemente. Foi conduzida uma síntese narrativa para identificar os resultados do estudo. Síntese dos dados: A pesquisa bibliográfica identificou 830 referências. Foram lidos 21 artigos na íntegra após avaliação dos critérios de inclusão. Finalmente, após a avaliação dos critérios de exclusão, apenas três estudos foram considerados para análise. Conclusões Crianças com doença hepática em preparação para o transplante podem apresentar defeitos de esmalte, pigmentação dentária, cárie, gengivite além de infecções oportunistas como a candidíase.
ABSTRACT
Este estudio evaluó la retención de conocimientos, de estudiantes de pregrado expuestos a una actividad educativa de detección de lesiones de caries. Estudiantes de Odontología de los últimos años fueron invitados a participar del estudio. Ellos recibieron la capacitación 1 año y medio antes. Para evaluar su retención de conocimientos se realizaron evaluaciones teóricas y prácticas para dimensionar los conocimientos, habilidades y actitudes de los estudiantes. Cada prueba se valoró entre 0 a 10. Análisis de regresión multinivel se usaron para ver la asociación entre el desempeño de los estudiantes y su percepción sobre la importancia de la actividad. Otras peculiaridades relacionadas al desempeño en temas específicos y diferentes tipos de evaluación también fueron estudiadas. 302 estudiantes fueron evaluados. En promedio, los estudiantes tuvieron una nota 6.68 para la teórica y 5.5 para la práctica, con desviación estándar de 1.88 y de 2.27, respectivamente. La percepción de los estudiantes sobre la actividad didáctica fue asociada a su desempeño. En la evaluación teórica, los estudiantes fueron peores al relacionar la condición clínica con la histológica (21% de aciertos) y al justificar su conducta frente a lesiones inactivas (36% de aciertos). En la evaluación práctica, el 70-90% de los estudiantes demostraron tener capacidad para detectar, valorar la actividad y tomar decisiones clínicas sobre lesiones iniciales y severas. Solo 50% detectó correctamente lesiones moderadas y 32% sabe su manejo. Concluimos que la retención de conocimientos de los alumnos en mediano plazo es moderada está dentro de lo esperado.
Este estudo avaliou a retenção de conhecimento, em médio prazo, de graduandos expostos a uma atividade educativa de detecção de cárie. Esta é uma parte do estudo multicêntrico IuSTC. Alunos dos últimos anos foram convidados a participar e passaram pela atividade. Foram avaliados quanto à retenção do conhecimento após 1,5 ano. Avaliações teóricas e práticas (pontuadas de 0 a 10) foram preparadas para avaliar conhecimento, habilidades e atitudes. Os escores foram definidos como desfechos. Análises de regressão multinível testaram a associação entre a performance dos alunos e sua percepção sobre a importância da atividade dentro do seu currículo. Particularidades relacionadas à performance em tópicos específicos e diferentes tipos de avaliação também foram explorados. 302 alunos participaram das avaliações. Em média, os alunos tiveram medias (desvio-padrão (DP), de 6,68 (1,88) teórica e 5,5 (2,27) prática. A percepção dos alunos esteve associada com sua performance. Na avaliação teórica, os alunos tiveram pior performance ao relacionar a condição clínica com a histológica (21% de acertos) ou em justificar a conduta frente a lesões inativas (36% de acertos). Na avaliação prática, 70-90% dos alunos demonstraram habilidade de detectar, avaliar atividade e tomar decisões clínicas frente a lesões iniciais e severas, enquanto 50% avaliaram adequadamente as lesões moderadas e apenas 32% demonstrou atitude correta do manejo. Em conclusão, a retenção do conhecimento dos alunos está dentro do esperado em uma análise de médio prazo. Para alguns tópicos (por exemplo, relacionados a prática e justificativa de atitudes), a performance dos alunos tende a ser pior.
This study aimed to evaluate undergraduate students' medium-term knowledge retention after a learning activity related to caries lesions detection. This study is part of the IuSTC multicenter study. Last-years dental students were invited to participate and were exposed to the teaching activity. Their knowledge retention after 1.5 year was assessed. Theoretical and practical tests (scored 0 to 10) were prepared to evaluate knowledge, abilities and attitudes The scores were set as outcomes. Multilevel regression analyses were used to assess the association between students' performance and his/her perception about the importance of such learning activity in curriculum. Particularities related to students' performance in specific topics and types of evaluations were also explored. 302 students participated. On average, students achieved 6.68 (SD=1.88) in theoretical and 5.5 (SD=2.27) in practical assessment. Student's perception was associated with their performance. In theoretical test, students performed worse (21% of correct answers) in linking clinical and histological condition or justifying clinical decision-making for inactive lesions (36% of correct answers). In the practical test, 70-90% demonstrated ability to detect, assess activity and make the decision about management of initial or severe lesions, while 50% of students could assess adequately moderate caries lesions and only 32% demonstrated correct attitude related to their management. Undergraduate students' knowledge retention related to the detection of caries lesions is moderate in a medium-term analysis. It is noted that for some topics (e.g. not related to practice/justification of attitudes), the students' performance tends to be worse.
Subject(s)
Humans , Male , Female , Students, Dental , Regression Analysis , Dental Caries , Knowledge , Mentoring , LearningABSTRACT
Abstract Oral health personnel must acknowledge the health needs of sexual and gender minorities. They should consult scientific literature to deepen their knowledge about sexuality, gender identity, general and oral health status, and treatment disparities among LGBTQIA+ people. The aim of this scoping review was to portray the development and current stage of internationally indexed literature approaching the oral health of this population. In this study, the search strategy used consisted of combinations of subject descriptors (MeSH terms), in two concept blocks: LGBTQIAP+ people and oral health. Global literature was searched through Medline (PUBMED), Web of Science, Embase, Lilacs, and Scopus electronic databases, with no language or date restrictions. Records were selected and evaluated by two independent reviewers, under the supervision of three senior reviewers and the inclusion criteria resulted in 189 eligible papers. Since the first study was published in 1974, numbers increased over the decades, reaching 67 (35.4%) in 2010-2019. The most frequently studied populations were North American (42.9%) and European (19.0%) and the most frequent language of publication was English (99.0%). There were 38 open access papers (20.1%). Medical (57.7%) and dental journals (20.1%) predominated. Cross-sectional studies were found more frequently (65.1%), followed by the cohort type (11.1%). Oral manifestation of STI (58.7%) was the topic most frequently addressed. The search for literature approaching the oral health of LGBTQIAP+ people showed evidence of the need to encourage research reported in papers made easily available, with more robust scientific evidence, and on a broader scope of topics, including oral health needs and treatment, and planning of oral health services.
ABSTRACT
Abstract The aim of this paper was to present a summary of the process of developing and preparing the final documents of the national consensus for teaching undergraduate Brazilian dental students the dental caries curriculum in the Portuguese language. The final document was developed in three steps: a) The ABENO and LAOHA cariology group invited experts from all five regions of Brazil to participate in the discussion. The theoretical support for crafting the first draft of the consensus was based on two publications: National Curriculum Guidelines of the Dentistry graduation in Brazil, Ministry of Education (2021) and the competences described in the European Core Curriculum for Cariology (ORCA-ADEE, 2011); b) The group of experts was divided into 5 working groups: G1-Domain, Main and Specific Competences, G2-Essential knowledge, G3-Life course perspective, G4-Social determinants and dental caries, G5- Glossary. The document was finalized by thoroughly reviewing the process using Delphi methodology; c) The 5-chapter document (one from each working group) was submitted to three open public consultations in 2022 (May-June, August, and October) using Google-forms. The suggestions (content/wording) were discussed within the group as: totally accepted, partially accepted, and rejected. A total of 192 suggestions were registered from 31 dental schools in all regions of Brazil. The number of suggestions received per Group were: 84, 28, 26, 24, 30 suggestions for G1, G2, G3, G4 and G5, respectively. The majority of suggestions were totally accepted by the group of experts (n = 172, 89.6%), 15 were partially accepted (7.8%), and 5 were rejected. Conclusion The final document could be considered to be the first national consensus for teaching the dental caries curriculum in Brazil.